Wiadomosci lekarskie最新文献

{"title":"Comparative characteristics of structural changes in the kidneys of experimental rats 1 and 3 hours after exposure to the Leiurus macroctenus scorpion venom.","authors":"Ruzhena M Matkivska, Inga A Samborska, Oleksandr Ye Maievskyi","doi":"10.36740/WLek/222245","DOIUrl":"https://doi.org/10.36740/WLek/222245","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To compare structural changes in the kidneys of experimental rats 1 and 3 hours after exposure to the Leiurus macroctenus scorpion venom.</p><p><strong>Patients and methods: </strong>Materials and Methods: The venom of scorpions from the Buthidae family, genus Leiurus, species Leiurus macroctenus, was administered to rats (0.5 ml of venom solution; 28.8 μg/ml; LD50=0.08 mg/kg). The study utilised 20 white male laboratory rats weighing 200 g (±10 g). The selected rats were divided into two groups: a control group - 10 rats, to which no venom was administered, and biological material was collected 1 and 3 hours after the administration of saline solution experimental group of 10 rats, from which histological material was collected 1 and 3 hours after the administration of the scorpion venom. For microscopic examination, kidney samples were taken from all groups. The specimens were fixed in a 10% formalin solution for 1 day. Histological samples of rat kidneys were stained with haematoxylin and eosin. Histological slides were examined using an SEO SCAN light microscope.</p><p><strong>Results: </strong>Results: One hour after the administration of Leiurus macroctenus scorpion venom to rats, significant hemodynamic disorders and the onset of inflammatory processes in the organ were noted, along with acute renal failure due to severe damage to the glomerular apparatus. Disruptions in the cytoskeleton of podocytes and the tubular apparatus of nephrons, along with manifestations of desquamation, hydropic, and hyaline-droplet dystrophies of the tubular epithelium, were established. The introduction of Leiurus macroctenus scorpion venom to rats was accompanied by markedly pronounced dystrophic changes in the structural components of the kidneys three hours after the beginning of the experimental study, in contrast to the earlier time point of the study. The emergence of inflammatory processes in the organ interstitium, characterised by plasmacytic, lymphocytic, and macrophage infiltration, was observed. Vascular and hemodynamic disorders were also detected, manifesting as desquamation of the endothelial lining of the vascular wall and increased permeability. The development of tubular necrosis characterised the renal tubular apparatus.</p><p><strong>Conclusion: </strong>Conclusions: More pronounced histological changes in the structural organisation of rat kidneys were found 3 hours after exposure to Leiurus macroctenus scorpion venom than after 1 hour of study.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 7","pages":"1563-1571"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysregulation of immune and stress responses in post-traumatic stress disorder: Increased inflammation and altered stress signalling pathways.","authors":"Ewa Alicja Ogłodek","doi":"10.36740/WLek/222497","DOIUrl":"https://doi.org/10.36740/WLek/222497","url":null,"abstract":"<p><strong>Objective: </strong>Aim: The aim of this review is to summarize current knowledge on the interplay between immune activation and stress-response dysregulation in post-traumatic stress disorder, with particular emphasis on molecular and neurobiological mechanisms.</p><p><strong>Patients and methods: </strong>Materials and Methods: This narrative review was based on a structured search of the PubMed, Scopus, and Web of Science databases, including studies published between 2010 and 2025. Keywords related to post-traumatic stress disorder, inflammation, cytokines, stress response, and neuroendocrine regulation were used. Clinical and experimental studies addressing stress-immune interactions were included. Post-traumatic stress disorder is increasingly conceptualized as a systemic condition involving persistent dysregulation of neuroendocrine and immune pathways. Disturbances of the hypothalamic-pituitary-adrenal axis, including altered glucocorticoid receptor sensitivity and impaired negative feedback regulation, coexist with increased sympathetic nervous system activity. These abnormalities promote activation of pro-inflammatory transcription factors such as nuclear factor kappa B and increased production of cytokines, including interleukin-1 beta, interleukin-6, tumour necrosis factor alpha, and interleukin-18. Additional mechanisms include activation of the NLR family pyrin domain containing 3 inflammasome, oxidative stress, mitochondrial dysfunction, and microglial activation, which contribute to neuroinflammation and impaired synaptic plasticity. These processes are associated with both psychiatric symptoms and increased risk of cardiovascular and metabolic comorbidities.</p><p><strong>Conclusion: </strong>Conclusions: Post-traumatic stress disorder may be understood as a disorder of maladaptive stress-immune interaction. Targeting inflammatory pathways and stress-response mechanisms may improve diagnostic approaches and support the development of personalized therapeutic strategies.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 7","pages":"1667-1675"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and epidemiological characteristics and risk factors for the development of recurrent respiratory diseases in children.","authors":"Olesya M Horlenko, Оksana М Berezovska, Valeriya V Brych, Іryna Yu Pikina, Оlga V Zolina, Volodymyr D Symulyk, Ivan I Pushkash","doi":"10.36740/WLek/225983","DOIUrl":"https://doi.org/10.36740/WLek/225983","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To investigate the influence of risk factors on the development of recurrent respiratory diseases, to analyze clinical and epidemiological components for the possibility of their prevention.</p><p><strong>Patients and methods: </strong>Materials and Methods: The research was conducted on the basis of the Uzhhorod Children Primary School. Children studied groups (n=118) aged 6-9 years with a diagnosis of \"acute recurrent respiratory diseases\" were formed.</p><p><strong>Results: </strong>Results: Childrens inflammatory episodes were most often observed, in particular: bacterial tonsillitis - 86 (72,89%), otitis - 56 (47,46%), pneumonia and sinusitis - 37 (31,36%) (identical indicators). In our study, respiratory infection caused by at least one pathogen was observed in 63,4±4,1% of patients. The proportion of viral infections was 48,34±3,6%, in particular, coinfections were identified in 36,4±2,9% of cases. The distribution of confirmed viruses is as follows: AdV (26,34±1,7%), SARS-CoV-2 (19,5±1,6%), RV (18,2%), RSV (17,8%), influenza A/B (11,4%) and others in minimal structural components (6.8%).</p><p><strong>Conclusion: </strong>Conclusions: Recurrent respiratory tract infection is a multifactorial disease caused by a complex interaction of environmental and host factors. We suggest that an \"additive effect,\" depending on the number of factors involved, most of which may be underestimated, may be a plausible explanation for the recurrence of respiratory tract infection in a significant proportion of healthy children with unexplained frequent respiratory symptoms.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 7","pages":"1540-1548"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular profiling of apoptotic, inflammatory, and angiogenic markers in prostate cancer: Focus on p53, IL-6, IL-8, Bax/Bcl-2 ratio, and VEGF.","authors":"Mayada Hameed Al-Khafaji, Wrood Majid Hameed, Dhifaf Mohsin Shalla, Karima Akool Al-Salihi","doi":"10.36740/WLek/220739","DOIUrl":"https://doi.org/10.36740/WLek/220739","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To perform a comprehensive molecular profiling of key apoptotic, inflammatory, and angiogenic markers - p53, IL-6, IL-8, Bax/Bcl-2 ratio, and VEGF -in peripheral blood samples of patients with prostate cancer.</p><p><strong>Patients and methods: </strong>Materials and Methods: A total of 60 male participants were enrolled in the study, comprising 40 patients with histologically confirmed prostate cancer and 20 age-matched healthy controls. The median age in both groups was 68 years (range: 55-78). Patients were stratified according to Gleason score, PSA levels, and tumor stage from the begging of August 2024 to the end May 2025. Blood samples from patients suffering Prostate cancer (PCa). ELISA Human-specific ELISA kits (e.g., from R&D Systems, BioLegend, or Abcam) (from Serum) for IL-6, IL-8, VEGF. As well as Bax/Bcl-2 Ratio. RNA Quality Check: The concentration and integrity of RNA will be evaluated using a NanoDrop agarose gel. cDNA Synthesis: A reverse transcription kit (such as Thermo Fisher's High-Capacity cDNA Reverse Transcription Kit) will be used to create cDNA from 1 μg of RNA. Target Genes p53, Primers, and Probes for Quantitative Real-Time PCR (qRT-PCR).</p><p><strong>Results: </strong>Results: p53 Expression, qPCR analysis revealed significantly decreased expression of p53 mRNA in prostate cancer patients compared to controls (mean ΔCt = 6.1 ± 0.8 vs. 4.3 ± 0.6; p < 0.001. Serum IL-6 levels (by ELISA) were elevated in prostate cancer patients (mean = 18.4 ± 6.2 pg/mL) compared to controls (7.1 ± 2.3 pg/mL); p < 0.001. Similarly, IL-8 levels were significantly higher in patients (27.5 ± 9.8 pg/mL) than in controls (10.2 ± 3.5 pg/mL); p < 0.001. Serum VEGF concentrations were significantly increased in prostate cancer patients (median = 296 pg/mL; IQR = 230-360 pg/mL) compared to controls (median = 122 pg/mL; IQR = 90-160 pg/mL); p < 0.0001.</p><p><strong>Conclusion: </strong>Conclusions: Prostate cancer patients exhibited decreased p53 and Bax/Bcl-2 ratio, indicating impaired apoptosis. IL-6 and IL-8 were significantly elevated and positively correlated, reflecting a pro-inflammatory environment.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 7","pages":"1598-1605"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An indicative model of compulsory health insurance.","authors":"Mykhailo D Diachuk, Dmytro D Diachuk, Viktoriia V Horachuk","doi":"10.36740/WLek/222577","DOIUrl":"10.36740/WLek/222577","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To propose an indicative model of compulsory health insurance in the context of a significant deficit in budget financing of the healthcare sector and a decrease in the population's financial access to medical care.</p><p><strong>Patients and methods: </strong>Materials and Methods: The search strategy involved the use of the keywords \"health insurance\", \"health financing\", \"affordability\", \"patients\", \"healthcare\", \"insurance companies\".The primary selection of materials was based on the analysis of the titles and abstracts of publications in accordance with the previously defined inclusion and exclusion criteria, formed according to the research topic. Of the 69 publications found, 21 were used. Methods used in the study: bibliographical, medical-statistical, analytical, graphical, functional-structural modelling, generalisation. The average salary \"in hand\" was calculated by subtracting from the average salary, according to official Ukrainian government sources (gov.ua, Ministry of Finance of Ukraine), personal income tax - 18.0% and military levy - 1.5% for the period until 01.12.2024; from 01.12.2024 the military levy increased to 5.0%. The real wage index, taking into account tax payments, was calculated according to the Methodology for calculating real wage indices.</p><p><strong>Conclusion: </strong>Conclusions: The proposed model is aimed at increasing the financial accessibility of medical care for the population, minimising the risks of inefficient use of resources, and strengthening the preventive component in health care. Its implementation requires further regulatory and organisational support.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 6","pages":"1357-1363"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The right to psychiatric assistance in places of deprivation of liberty: european standards.","authors":"Olga Tyshchenko, Andrii Hnatiuk, Inna Bespalko","doi":"10.36740/WLek/213764","DOIUrl":"10.36740/WLek/213764","url":null,"abstract":"<p><strong>Objective: </strong>Aim: The article aims to deepen the scientific discussion on ensuring the right to psychiatric assistance in places of deprivation of liberty.</p><p><strong>Patients and methods: </strong>Materials and Methods: In preparing the article, the following were examined: the provisions of international legal instruments regulating adequate treatment of persons suffering from mental disorders; relevant legal positions of the European Court of Human Rights in this regard; and scholarly research within the outlined vector of scientific inquiry. The methodological basis of the study consists of dialectical, comparative-legal, systemic-structural, analytical, synthetic, and comprehensive methods.</p><p><strong>Conclusion: </strong>Conclusions: The current case law of the European Court of Human Rights indicates that subparagraph \"e\" of paragraph 1 of Article 5 of the Convention for the Protection of Human Rights and Fundamental Freedoms (lawful detention of persons of unsound mind) serves two protective functions: a social one (ensuring the protection of society) and a therapeutic one (providing the person with adequate treatment while in detention). The comprehensive concept of \"adequate treatment of a person suffering from mental disorders\" includes the following components: a) an individual treatment plan; b) an appropriate institution; c) the language in which the treatment is provided. Adequate treatment is an integral part of the concept of an \"appropriate institution\". The right to adequate treatment becomes illusory if there is a language barrier between the medical staff and the patient suffering from mental disorders.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 2","pages":"417-424"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience and professional identity of medical students during wartime: The Ukrainian experience.","authors":"Kateryna O Hololobova, Lesya V Lymar, Volodymyr S Tytykalo, Olena I Kefeli-Ianovska, Ganna S Trepet, Tetyana V Kolomiiets","doi":"10.36740/WLek/222578","DOIUrl":"https://doi.org/10.36740/WLek/222578","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To conduct an empirical analysis of resilience self-assessment and professional intentions among medical students and PhD students in Ukraine under the conditions of full-scale war, and to determine the impact of crisis conditions on the formation of their professional identity.</p><p><strong>Patients and methods: </strong>Materials and Methods: The study is based on the results of an anonymous cross-sectional survey (2025) conducted among students at Bogomolets National Medical University (N=214). Statistical data processing included the calculation of proportions and the margin of error (MOE) for a 95% confidence interval. Empirical data were supplemented by a content analysis of 39 relevant publications from the PubMed and Scopus databases (2022-2026).</p><p><strong>Results: </strong>Results: The sample exhibited a distinct gender imbalance (75.2% female). Despite significant psychological pressure, a high level of resilience was recorded: 63.1% of respondents rated their adaptability above average (over 51%). Strong professional loyalty was observed, with 65.4% of participants planning to continue their activities in Ukraine. Conversely, 26.6% of students remain «undecided», indicating the vulnerability of human capital due to the erosion of traditional social support mechanisms. The war has accelerated professional maturation through engagement in volunteering and tactical medicine, signaling processes of post-traumatic growth.</p><p><strong>Conclusion: </strong>Conclusions: The full-scale war has transformed the professional «ego» of future physicians toward practical readiness and social responsibility. Continuity of education in crisis conditions requires the integration of flexible distance models with enhanced psychosocial mentorship. The results underscore the necessity of institutional support for students to preserve the human capital of the Ukrainian healthcare system.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 6","pages":"1286-1291"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromolecular biomarkers of traumatic stress: Refining diagnostic criteria and personalizing treatment for core biological symptoms in PTSD.","authors":"Ewa Alicja Ogłodek","doi":"10.36740/WLek/221167","DOIUrl":"https://doi.org/10.36740/WLek/221167","url":null,"abstract":"<p><strong>Objective: </strong>Aim: The aim of this review is to assess the role of neuromolecular biomarkers in post-traumatic stress disorder (PTSD) and their usefulness in improving diagnostic accuracy and supporting personalized treatment strategies.</p><p><strong>Patients and methods: </strong>Materials and Methods: A narrative review of studies published between 2015 and 2025 was performed using databases such as PubMed, Scopus, and Web of Science. The analysis included clinical and experimental studies focusing on neuroinflammation, oxidative stress, endoplasmic reticulum stress, and markers of neuronal damage in PTSD. Special attention was given to associations between biomarkers and symptom severity, duration of illness, and treatment outcomes.</p><p><strong>Results: </strong>Results: PTSD is associated with disturbances in neuroimmune and neuroendocrine pathways. Increased levels of pro-inflammatory cytokines, including interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and interleukin-18 (IL-18), are frequently observed. Activation of the NLR family pyrin domain containing 3 inflammasome (NLRP3 inflammasome) and elevated oxidative stress markers, such as malondialdehyde (MDA), indicate ongoing inflammatory and oxidative processes. Changes in neuronal injury markers, including ubiquitin carboxyl-terminal hydrolase L1 (UCHL1), suggest neurodegenerative mechanisms. Altered chemokine signaling, particularly fractalkine (chemokine C-X3-C motif ligand 1, CX3CL1), and activation of endoplasmic reticulum stress pathways, such as inositol-requiring enzyme 1 (IRE1) and activating transcription factor 6 (ATF6), are linked to impaired neuronal function and reduced synaptic plasticity. These findings indicate biological heterogeneity within PTSD.</p><p><strong>Conclusion: </strong>Conclusions: Neuromolecular biomarkers may improve the current symptom-based diagnostic model of PTSD. Their integration with clinical assessment tools may support identification of biologically defined subgroups and enable more targeted treatment.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 6","pages":"1372-1381"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical stage of dental implant placement with immediate loading: Indications and contraindications.","authors":"Sviatoslav A Ohiienko, Davyd S Avetikov, Oksana H Popadynets, Tetiana Yu Ohiienko, Yaroslav V Piuryk, Larysa Ya Fedoniuk","doi":"10.36740/WLek/225508","DOIUrl":"https://doi.org/10.36740/WLek/225508","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To analyze the scientific literature on indications for and contraindications to dental implant placement using immediate loading protocols.</p><p><strong>Patients and methods: </strong>Materials and Methods: The scientific literature reporting clinical situations corresponding to absolute and relative indications for and contraindications to dental implant placement with immediate loading was reviewed.</p><p><strong>Conclusion: </strong>Conclusions: The literature reports that one-stage implant placement with immediate loading and simultaneous placement of a transmucosal healing abutment or abutment has demonstrated effectiveness in clinical practice. However, despite its advantages, this approach has certain limitations. While absolute indications are largely determined by the potential to preserve the volume of hard and soft tissues, relative indications necessitate modifications to the existing protocol, including measures for infection control, gap management, potential biotype thickening, and modulation of the immune response. In analyzing relative contraindications, particular attention should be paid to the patient's medical history, metabolic status, the presence or absence of inflammatory processes, and the potential for their correction in collaboration with a multidisciplinary team to prevent iatrogenic injury. The implementation of modern diagnostic algorithms and biotechnologies may reduce the range of absolute contraindications; however, this approach requires careful analysis. In experimental and clinical studies aimed at improving diagnostic algorithms and strategies for modulation of homeostasis, a personalized approach can reduce the number of relative contraindications to immediate implant placement.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 6","pages":"1421-1429"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of psychoemotional state on the intensity and nature of pain after hysteroscopic myomectomy.","authors":"Оlena O Lytvak, Liliia I Martynova, Dmytro O Govsieiev","doi":"10.36740/WLek/222586","DOIUrl":"https://doi.org/10.36740/WLek/222586","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To assess the impact of psychoemotional status indicators (state anxiety, trait anxiety, and depression) on the intensity and duration of postoperative pain syndrome in patients after hysteroscopic myomectomy, and to determine their prognostic value for optimising analgesic management under conditions of wartime stress.</p><p><strong>Patients and methods: </strong>Materials and Methods: Ninety reproductive-age patients with submucosal uterine fibroids were examined. Group 1 (n=62) included women living under wartime stress in Ukraine: subgroup 1.1 (n=32) internally displaced persons and subgroup 1.2 (n=30) residents of Kyiv. Group 2 (n=28) comprised Ukrainian women temporarily living abroad who returned to Kyiv for planned surgery. Psychoemotional status was assessed using the Spielberger-Hanin and Beck scales, and pain using the NRS scale. Statistical analysis used nonparametric methods and ROC analysis.</p><p><strong>Results: </strong>Results: Anxiety levels differed significantly between all groups (p<0.001), highest in internally displaced persons. Subgroups 1.1 and 1.2 had higher NRS pain scores and required the maximum daily dexketoprofen dose (150 mg) compared with group 2. ROC analysis showed state anxiety strongly predicts acute pain intensity (AUC=0.804), while depression predicts pain duration in the outpatient setting (AUC=0.860).</p><p><strong>Conclusion: </strong>Conclusions: Wartime stress significantly modulates pain perception by lowering the pain threshold even during hysteroscopic myomectomy. State anxiety correlates with acute postoperative pain intensity, while depressive states are associated with prolonged pain and the risk of chronification. These findings support personalised analgesia that considers patients' psychoemotional profiles.</p>","PeriodicalId":23643,"journal":{"name":"Wiadomosci lekarskie","volume":"79 6","pages":"1266-1272"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}